CMS will pay 340B hospitals at average sales price plus 6 percent — rather than average sales price minus 22.5 percent — for all calendar year 2022 drug claims with modifier "JG," the American Hospital Association said Oct. 20.
The announcement comes after a federal judge ruled Sept. 28 that HHS must immediately cover 340B drug costs rather than wait until 2023.
HHS said Sept. 30 it needed two weeks to put a plan in place because required "revisions to four different electronic data files and then testing by multiple offices to confirm that the revised files function appropriately before the files are loaded to the production environment where they will be used to calculate OPPS reimbursements on a prospective basis."
In June, the Supreme Court ruled in favor of hospitals on part of the 340B program — which allows eligible hospitals to buy discounted outpatient drugs — and said HHS could not vary the program's reimbursement, which it did in 2018 by lowering it by 28.5 percent and then later to 22.5 percent.